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Abstract

Background and objective The birth of a preterm infant can be an overwhelming experience of guilt, fear and helplessness for parents. Provision of interventions to support and engage parents in the care of their infant may improve outcomes for both the parents and the infant. The objective of this systematic review is to identify and map out effective interventions for communication with, supporting and providing information for parents of preterm infants.

Design Systematic searches were conducted in the electronic databases Medline, Embase, PsychINFO, the Cochrane library, the Cumulative Index to Nursing and Allied Health Literature, Midwives Information and Resource Service, Health Management Information Consortium, and Health Management and Information Service. Hand-searching of reference lists and journals was conducted. Studies were included if they provided parent-reported outcomes of interventions relating to information, communication and/or support for parents of preterm infants prior to the birth, during care at the neonatal intensive care unit and after going home with their preterm infant. Titles and abstracts were read for relevance, and papers judged to meet inclusion criteria were included. Papers were data-extracted, their quality was assessed, and a narrative summary was conducted in line with the York Centre for Reviews and Dissemination guidelines.

Results Interventions for supporting, communicating with, and providing information to parents that have had a premature infant are reported. Parents report feeling supported through individualised developmental and behavioural care programmes, through being taught behavioural assessment scales, and through breastfeeding, kangaroo-care and baby-massage programmes. Parents also felt supported through organised support groups and through provision of an environment where parents can meet and support each other. Parental stress may be reduced through individual developmental care programmes, psychotherapy, interventions that teach emotional coping skills and active problem-solving, and journal writing. Evidence reports the importance of preparing parents for the neonatal unit through the neonatal tour, and the importance of good communication throughout the infant admission phase and after discharge home. Providing individual web-based information about the infant, recording doctor–patient consultations and provision of an information binder may also improve communication with parents. The importance of thorough discharge planning throughout the infant's admission phase and the importance of home-support programmes are also reported.

Conclusion The paper reports evidence of interventions that help support, communicate with and inform parents who have had a premature infant throughout the admission phase of the infant, discharge and return home. The level of evidence reported is mixed, and this should be taken into account when developing policy. A summary of interventions from the available evidence is reported.

Funding The study was funded by the Big Lottery Fund (grant number: RG/1/01014958), and the collaborating organisations included the Royal College of Nursing Research Institute, University of Warwick, the National Childbirth Trust (NCT), the National Perinatal Epidemiology Unit (NPEU), Univeristy of Oxford, the Warwickshire NCT Pre-term Support Group and BLISS, the premature baby charity.

Ethics approval Ethics was provided by MREC, South East Ethics Research Unit (ref: 06/MRE 01/6).

Contributors JB made substantial contributions to the design, acquisition of data, and analysis and interpretation of the data, and wrote the first draft of the paper. JB wrote the first amendments to the draft paper and the first draft of responses to the reviewers. SS was the principal investigator of the POPPY study, obtained funding for the study, made substantial contributions to the conception and design of the study, assisted in the selection of papers and the quality assessment of papers, assisted with the interpretation of the data, assisted in the writing of the first draft of the paper and approved the version for publication. MN was the fund holder, made substantial contributions to the conception and design of the study, assisted in the interpretation of the data, revised drafts of the paper and approved the version for publication. NJ was the patient representative on this study, made substantial contributions to the conception and design of the study, assisted in the interpretation of the data, revised drafts of the paper and approved the version for publication. LT was a representative of the National Childbirth Trust and a patient representative. She made substantial contributions to the conception and design of the study, assisted in the interpretation of the data, revised drafts of the paper and approved the version for publication.

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